Where is pain most likely to be localized when a patient extends their great toe?

When a patient extends their great toe, the pain is most likely to be localized at the L5 level. This is due to the fact that the primary nerve root responsible for the extension of the great toe is the L5 nerve root.

In the lumbar spine, the L5 nerve root innervates the muscles that control the extension of the great toe, particularly the extensor hallucis longus muscle. Therefore, if there is irritation or compression of the L5 nerve root—perhaps due to a herniated disc or foraminal stenosis— patients may experience localized pain as a result of extending the great toe.

The anatomy of the lumbar spine indicates that the other levels (L3, L4, and S1) are associated with different functions and areas of the lower extremity. For example, L3 is connected to knee extension and sensory innervation to the anterior thigh, L4 is also involved in knee extension but extends to the medial leg and foot, while S1 is more associated with the lateral aspect of the foot and calf movement rather than toe extension. Thus, L5 is specifically categorized for the function and sensation related to the great toe's extension, making it the site where pain is most likely to manifest in